Table 2.
Summary of studies showing association between race and COVID-19-induced AKI.
| Study | Design | Clinical Setting | Population Characteristics | AKI Definition |
Patients with AKI | Risk of AKI | Outcomes |
|---|---|---|---|---|---|---|---|
| Fisher et al., 2020 [28] | Retrospective observational study | New York City Health System | Hospitalized adult patients with or without COVID-19 (n = 9859) | KDIGO | Black (40.5%), White (8.2%), Hispanic (33.5%), Other (17.8%) | Black race was associated with AKI (adjusted odds ratio, 1.7; 95% CI, 1.3 to 2.3) | Incident AKI, composite need for RRT or mortality |
| Hirsch et al., 2020 [49] | Retrospective observational cohort study | New York Health System | Hospitalized adult COVID-19-positive patients (n = 5449) | KDIGO | Black (20.8%), White (41.0%), Asian (8.1%), Mixed (25.4%), Other (4.2%), Declined (0.4%) | Black race was an independent predictor of AKI (adjusted odds ratio, 1.23; 95% CI, 1.01 to 1.50) | Development of AKI, or RRT and hospital disposition (i.e., discharge or death) |
| Nimkar et al., 2020 [48] | Retrospective case series | New York City metropolitan teaching hospital | Hospitalized confirmed adult COVID-19 patients (n = 370) | KDIGO | Black (43%), White (33.5%), Hispanic (14.5%), Other (8.9%) | African American race showed higher odds of AKI (adjusted odds ratio, 2.1; 95% CI, 1.2 to 3.7 | AKI and mortality |
| Raharja et al., 2021 [55] | Systematic review and meta-analysis | MEDLINE, EMBASE, Cochrane, WHO COVID-19 databases | Seventy-two articles with COVID-19-positive participants (n = 17,950,989) | - | White (38%), Black (38%), Asian (5.2%), Hispanic (9.1%), Mixed/other (13%) | Unadjusted analysis showed Black ethnicity had a significantly higher risk of AKI (RR: 1.35, 95% CI: 1.04–1.76), but pooled RR was non-significant (RR: 1.60, 95% CI: 0.89–2.90) | All-cause mortality, hospitalization, critical care admission, invasive mechanical ventilation, extracorporeal membrane oxygenation, and AKI |
| Bowe et al., 2021 [50] | Observational cohort study | US Veterans Affairs population | Hospitalized COVID-19 patients (n = 5216) | KDIGO | Black (53%), White (42%), Other (5%) | Black race was a significant predictor of AKI (adjusted odds ratio, 1.93; 95% CI, 1.69 to 2.20) | All-cause mortality, discharge, need for mechanical ventilation, hospital length of stay |
| Charoenngam et al., 2021 [47] | Single-center retrospective cohort study | Boston Medical Center | Hospitalized adults with a positive SARS-CoV-2 PCR test (n = 1424) | ICD-10-CM codes | Black (39.4%), White (23.1%) | AKI was statistically significantly associated with Black race (adjusted odds ratio, 2.16; 95% CI, 1.57 to 2.97) | In-hospital mortality, intensive care unit admission, hospital morbidities, and inflammatory marker levels |
| Nugent et al., 2021 [56] | Retrospective cohort study | Yale New Haven Health System network | Hospitalized adult patients with positive COVID-19 and AKI; discharged and did not require dialysis within 3 days of discharge (n = 182) | KDIGO | Black (40.1%), White (40.7%), Asian (2.7%), Hispanic (22%), Other (16.5%) | - | Association between COVID-19-associated AKI and eGFR slope after discharge and time to AKI recovery |
| Bandelac et al., 2022 [57] | Retrospective study | The BronxCare Health System | Hospitalized adults with a positive SARS-CoV-2 PCR test (n = 1545) | KDIGO | Black (31.9%), White (1.6%), Hispanic (58.1%), Other (8.4%) | - | AKI, incidence, mortality, stage, and recovery of AKI |
AKI, acute kidney injury; KDIGO, kidney disease: improving global outcomes; CRRT, continuous renal replacement therapy; PIRRT, prolonged intermittent RRT; PD, peritoneal dialysis; HD, hemodialysis; ICD-10-CM, international classification of diseases, tenth revision, clinical modification; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; RR, relative risk.